TMI warning - Pelvic prolapse / posterior vaginal prolapse

[gullshelp]

Hello,

NC from usual username for this as embarrassing.

I'm waiting to see my Gp as I'm 8 months postpartum and despite Pelvic floor exercises I've had trouble emptying my bowels.

It didn't take long to search online and find an exact match to my symptoms. I have a rectocele or posterior vaginal prolapse.

Basically the wall between my vagina and rectum has prolapsed to create a pocket. Horrible but basically poo gets compacted in there and in order to empty my bowels I need to push it back up and into my rectum. It's not so severe that if has fully prolapsed and hangs outside my body (as I have read can happen) but going to the toilet is not pleasant.

Has anyone experienced this and how was it treated ? Did you need surgery and would you recommend this? The prospect terrifies my but I would rather like to be able to poo normally again.

Complicating factor is that I plan to try for a second baby fairly soon (DH and I are not getting any younger) and I wondered if:

A- vagjnal prolapse could cause issues in subsequent childbirth, eg better to get it sorted before txt

B- it would be better to get it sorted after having DC2.

I'd be grateful if people could share their experiences. I think this must be quite common!

Thank you.

Typo

A- vagjnal prolapse could cause issues in subsequent childbirth, eg better to get it sorted before TTC

I would strongly, strongly encourage you to seek out private treatment from a physio who specialises in women's health. You will not receive timely treatment via the NHS, unfortunately.

You deserve to be treated as soon as possible.

I have this as well as a bladder prolapse . I've seen a gynecologist but have been referred to another one. Mainly because I have a mesh TVT and it's not worked.
The new prolapse is connected to having a hysterectomy.
I'm going to see a pelvic health physio in 2 weeks.
You will be need to be referred by your GP.
It will help if you put your feet up when pooing, I use a small stool.

See your GP ASAP. Go private if possible. You need to keep your bowls movements smooth - lots of fibre and stay well hydrated.

Buy a stool to raise your feet when you have a bowel movement.

Breathe out the stool and take your time, do not push / strain.

Look up "splinting" - this may help you. Not pleasant but can be necessary.

You need to have your prolapse assessed and graded. There are a number of options before surgery and if you are at the mid - mild range, you will not be offered surgery initially and prob won't need it. If you are going to have a second child, they will not give you surgery.

I'm having good results with physical therapy at the month, I have prolapse of both bladder and bowel, both mild to moderate.

It's horrid, but you're not alone. Xx

*at the moment

Hi

I have the same diagnosed by gynaecologist. I had a birth debrief and all appointments arranged direct with the hospital via this route (and help from PALS). GP was utterly useless. It took me until 18 months post delivery to tackle the issue.

I've delayed surgery as it isn't recommended unless you have finished having children due to poor recurrence rates. My life has been drastically improved via physio and a vegan diet. If I eat meat or dairy it's almost instant problems. There's many resources online, a brilliant Australian physio on YouTube teaching you how to empty your bowel. Search "how to correctly empty bowel" and will be one of the first items to come up. Good positioning and breathing is key, however I also splint if I am constipated and it's a technique try physio encourages if required.

Other things that helped me was to ensure never to strain as that can make it worse, high fibre diet and lots and lots of water!

Personally I've had a c section approved for any future dcs as my gyne could not guarantee another vaginal delivery wouldn't worsen the rectocele.

Thanks all,

Seeing Gp soon so will push for specialist assessment ASAP. Note the reccendation to go private - will have to look at costs. Have looked at splinting - I've been doing this I just didn't know it had a name ! Great advice about stool will start doing that ASAP.

I don't think mine is severe as it's hot hanging out etc.... mild - moderate I'd say.

If a have a second baby and my second labour is anything like my first.... I dread to think....

I had a rectocele repaired without using the mesh. You need to support your perineum using your fingers and a pad of tissue, to allow you to fully empty the bowel.

There are temporary measures like a silicone donut which supports the pelvic organs.

Cross post mumu thanks for all your advice.

Interesting to hear you've been advised to have a c-section for next baby. Would you say your rectocele is severe?

Thanks for sharing and support it's good to know that there are very similar cases around x

I've heard terrifying things about vaginal mesh.

OP you do not need to be referred by your GP to see a private physio.

I worried that I had a prolapse and I found a local private physio using the internet. I ascertained that she was a member of a reputable professional body, rang up, and booked an appt then and there.

If you are worried, I wouldn't wait.

Honestly, don't start worrying about mesh yet. A lot can be done with PT and a pessary :)

I've taken the decision not to have another child due to the effect a second pregnancy and birth is like to have on my birth injuries from the first. However, many women do go on to have a number more children with prolapse and then have surgery to correct any further damage.

As a guide OP, I paid £60 for an hour long initial consultation with follow up programme of exercises and ability to email thru further questions. I decided to continue appts and pay around £45-50 for follow ups every 8w.

I consider it money well spent.

I also have a friend who had a gynae issue that the GP was dithering over. She paid for a consultation with a consultant gynae at a private hospital which inc full internal exam, I think also an ultrasound and discussion of results. She said it was about £250. Most private hospitals have choose-n-book services where you can just book direct on the website.

So depending on how much cash you have to throw at the problem, you could probably get seen and assessed within a week or two if yiu wanted.

My prolapse is moderate. Hospital have been fantastic and had several appointments to discuss options.

I haven't been pushed in any direction just listened to my concerns and presented the options. For me cs is the best. My greatest fear is i do more damage, the pregnancy itself may cause this so I'm working with my physio to strengthen my pelvic floor. I use the squeezy app and have gone from what they called a "flutter" to level 4 (out of 5) in 6 months so it can be done.

I'm hyper mobile so genetically more prone to prolapse. I also had diastasis recti (split abs) so a bit of a car crash all round

Good luck, push for that referral and if the GP is not forthcoming (like mine) head straight to PALS for a debrief. I found once I got in the "system" everyone was so helpful and I started to make progress.

Just catching up on other posts. I have not vagina mesh proposed, but I'm having a diagnostic exam this week to determine if I'm a candidate for filler injections. Basically they inject the filler into the vaginal walls to strengthen the walls and gently push the prolapse back.

This is all NHS but I echo others recommendations do what you can to get the correct treatment. For health issues with my dc I have used private and then presented the letter to GP for NHS referral.

I’ve had/got this problem. Exercises can only help slightly as it’s a mechanical failure, so don’t waste money on paying a private physio. Instead do regular pelvic floor exercises. I saw a physio who said my muscles were quite good but that everything had stretched and no amount of exercises will reverse that.

I had a repair, which helped up to a point but I’m now back to where I was. I currently take Laxidol to keep my stools soft and I use a glycerol suppository before every bowel movement. These help no end.

I think surgery can help but I would wait until after you complete your family. In your shoes I would opt for a Caesarean section.

mesh is relatively new for this. I had a repair- cystocele and slight rectocele 25 years ago with no mesh. See a gynae for an assessment then take it from there. You can have other types of repair with no mesh.

I don't have advise but feel for you as also suffered from bladder prolapse after first child

I was so worried about the effect of my second child being born, but actually 9 months later it's totally fine now whereas i never recovered between births

So there is hope! I'd just crack on with your second child and sort it all after as they wait until you've had all your kids to fix it anyway

Seeing a specialist women's health physio will not be a waste - please don't just crack on doing random Pelvic floor exercises. You have no idea what damage you have. Whether you're doing them correctly. How many to do. How hard to squeeze. Whether there's any additional nerve damage. Or how to correctly manage your symptoms. Never mind building up to additional core exercises to support the whole Pelvic sling so everything works together properly.

You're a complex instrument! It will take time and hard work. PT might not be enough of a fix for you, but it won't harm to know what's going on and do stuff properly.

Seeing a physio is not a waste.

I saw a physio and then had surgical repair and 're episiotomy. However In less than a year it reccured. It depends if weak tissues is the reason it has occurred. I have a pelvic tens machine now. Now sure can do much more.

Oh my goodness . Will read through replies one by one and properly but just want to say how grateful fi am for the volume and thoughtfulness of responses. Until today I felt very alone a freakish esp re splinting. Have only just told DH today. How silly.

Definitely not a waste to see a physiotherapist. Just make sure they have a specialty in woman's health. Even if it's just to assess and give you a programme to work on. They will check that your technique with your PFEs are correct. So many woman do them incorrectly unfortunately. As a PP said, you shouldn't need to see them very regularly, every so often to progress your programme should be enough.

Thank you, digesting all now.

To confirm , are women's health physios available though NHS but the problem is gp's being rubbish / waiting times?

I'd like to see a physio and a gynaecologist esp re concerns around second vaginal delivery. May start with GP, see physio privately if progress not quick through nhs whilst also pushing for gynaecologist.

(Other than having DC1 I've not used nhs much or been referred for things so it's all very new to me).

Sar302 thanks for your replies and I'm sorry to hear of your birth injuries if you don't mind me asking, did you not feel c-section was an option? I'm only asking as others have said it was advised for them and it may be something for me to think about.

lovelylemurs am I right - you had a surgical repair but it failed?